Seven Indonesian Bird Flu Cases Linked to Patients (Update1)
May 23 (Bloomberg) -- All seven people infected with bird flu in a cluster of Indonesian cases can be linked to other patients, according to disease trackers investigating possible human-to-human transmission of the H5N1 virus.

A team of international experts has been unable to find animals that might have infected the people, the World Health Organization said in a statement today. In one case, a 10-year- old boy who caught the virus from his aunt may have passed it to his father, the first time officials have seen evidence of a three-person chain of infection, an agency spokeswoman said. Six of the seven people have died.

Almost all of the 218 cases of H5N1 infections confirmed by the WHO since late 2003 can be traced to direct contact with sick or dead birds. Strong evidence of human-to-human transmission may prompt the global health agency to convene a panel of experts and consider raising the pandemic alert level, said Maria Cheng, an agency spokeswoman.

``Considering the evidence and the size of the cluster, it's a possibility,'' Cheng said in a telephone interview. ``It depends on what we're dealing with in Indonesia. It's an evolving situation.''

The 32-year-old father in the cluster of cases on the island of Sumatra was ``closely involved in caring for his son, and this contact is considered a possible source of infection,'' The WHO said in its statement. Three others, including the sole survivor in the group, spent a night in a ``small'' room with the boy's aunt, who later died and was buried before health officials could conduct tests for the H5N1 virus.

`Directly Linked'

``All confirmed cases in the cluster can be directly linked to close and prolonged exposure to a patient during a phase of severe illness,'' the WHO said.

While investigators have been unable to rule out human-to- human transmission in the Sumatran cluster, they continue to search for other explanations for how the infections arose, the WHO statement said.

Health experts are concerned that if H5N1 gains the ability to spread easily among people, it may set off a lethal global outbreak of flu. While some flu pandemics are relatively mild, the 1918 Spanish flu pandemic killed an estimated 50 million people worldwide.

So far, studies of the Sumatran outbreak and genetic analyses of the virus don't indicate the virus has undergone major changes, Cheng said. Scientists at WHO-affiliated labs in the U.S. and Hong Kong found no evidence that the Indonesian strain of H5N1 has gained genes from pigs or humans that might change its power or spreading ability, WHO said.

Mutations

``These viruses mutate all the time and it's difficult to know what the mutations mean,'' Cheng said.

Health officials earlier found strong evidence of direct human-to-human spread of H5N1 in Thailand in 2004. Scientists reported in the Jan. 27, 2005, issue of the New England Journal of Medicine that the H5N1 virus probably spread from an 11-year- old girl in Thailand to her aunt and mother, killing the mother and daughter. People who had more casual contact with the girl didn't become infected.

In the Sumatran cluster, close, direct contact with a severely ill person was also needed for spread, Cheng said. Preliminary findings from the investigation indicate that the woman who died, considered to be the initial case, was coughing frequently while the three others spent the night in the same room. One of the three, a second brother, is the sole survivor. The other two, her sons, died.

``It looks like the same behavior pattern'' of close contact and caretaking during illness with the bird flu virus, Cheng said. To raise the level of pandemic alert ``it would have to be transmissible from more casual contact.''

General Community

The Indonesian Ministry of Health and international scientists are continuing their investigation to trace the origins of the infections, the WHO said in its statement.

``Priority is now being given to the search for additional cases of influenza-like illness in other family members, close contacts, and the general community,'' the WHO said. ``To date, the investigation has found no evidence of spread within the general community and no evidence that efficient human-to-human transmission has occurred.''

Re: Bird flu now suspected of being transmissable from person to person

Oh sweet Jesus! Nooooooooooo!!!!

May 23rd, 2006, 06:14 PM

Grimmlok

Re: Bird flu now suspected of being transmissable from person to person

If it has mutated to be transmissable between humans, you won't be able to contain it.

It'll be interesting to see what happens shortly.

May 23rd, 2006, 06:18 PM

LynnieD

Re: Bird flu now suspected of being transmissable from person to person

Yes it will be intersting. And scary.

Think that it could possibly be kept on that side of the globe?? Sigh.. I already know the answer to that. Just wishful thinking.

May 23rd, 2006, 06:44 PM

Grimmlok

Re: Bird flu now suspected of being transmissable from person to person

Yep.

On the plus side, we'll get rid of the surplus population in a hurry :)

No more old people on the roads!

May 23rd, 2006, 06:51 PM

A*O

Re: Bird flu now suspected of being transmissable from person to person

Quote:

Originally Posted by LynnieD

Think that it could possibly be kept on that side of the globe?? Sigh.. I already know the answer to that. Just wishful thinking.

Easy for you to say bitch - Indonesia is our next door neighbour! There is panic on the streets here (not) and we are all wearing our bacofoil hats in readiness.

May 23rd, 2006, 07:12 PM

Sojiita

Re: Bird flu now suspected of being transmissable from person to person

Quote:

Originally Posted by Grimmlok

Yep.

On the plus side, we'll get rid of the surplus population in a hurry :)

No more old people on the roads!

Think again smart guy! In the last huge pandemic 1918-1919, the people who were most susceptible to getting the flu and also dying from it were seemingly healthy people between the ages of 20 and 40. One of the strangest aspects of the whole thing. The young adults died in droves! better go out and stock up on the Tamiflu! lol

*on a side note..given my hypochondria..I am CERTAIN I have already acquired this disease!*:P

Quote:

Originally Posted by A*O

Easy for you to say bitch - Indonesia is our next door neighbour! There is panic on the streets here (not) and we are all wearing our bacofoil hats in readiness.

When it sweeps through Indonesia, panicked refugees will swarm into Australia in their teeming millions! It is the END OF DAYS! LOL!:D

May 23rd, 2006, 08:04 PM

Wonderwoman

Re: Bird flu now suspected of being transmissable from person to person

I just hope my hypochondriac CANADIAN aunt does not read this...... Yikes!

May 23rd, 2006, 08:11 PM

LynnieD

Re: Bird flu now suspected of being transmissable from person to person

Quote:

Originally Posted by A*O

Easy for you to say bitch - Indonesia is our next door neighbour! There is panic on the streets here (not) and we are all wearing our bacofoil hats in readiness.

Not for Ausssies AO!! No way!! Just those other countries that are up to no good! North Korea (far away I know), Indonesia and all those nuts. Hell, I love Koala Bears and Olivia Newton John as much as the next person.....

Seriously, it's all just scary. And I hope it doesn't go ANYWHERE.

You're welcome to stay at my house anytime AO if you need a quick place to flee to. You'll be safe here in upstate NY. At least for a bit.

May 24th, 2006, 12:05 AM

Grimmlok

Re: Bird flu now suspected of being transmissable from person to person

Bird flu only seems to kill off children and old people. The middle range (the useful one) is left pretty much untouched ;)

MWAHAHAH

May 24th, 2006, 12:51 AM

A*O

Re: Bird flu now suspected of being transmissable from person to person

^^^ ie it's like any other flu. The 1918 'Spanish' flu pandemic actually killed more people than died during the First WW during the previous 4 years. People always talk about that pandemic as being the 'model' for the next one but it's nearly 100 years later. Medical science has moved on since then and although the very young/old will still be vulnerable (it's called Natural Selection) I really don't buy the dire predictions of untold millions dying, especially in otherwise healthy specimens with access to state of the art medical treatment. Unfortunately, remote populations or those in the third world will probably be decimated, but it was ever thus (cf HIV/AIDS).

May 24th, 2006, 02:59 AM

Sojiita

Re: Bird flu now suspected of being transmissable from person to person

Quote:

Originally Posted by A*O

^^^ ie it's like any other flu. The 1918 'Spanish' flu pandemic actually killed more people than died during the First WW during the previous 4 years. People always talk about that pandemic as being the 'model' for the next one but it's nearly 100 years later. Medical science has moved on since then and although the very young/old will still be vulnerable (it's called Natural Selection) I really don't buy the dire predictions of untold millions dying, especially in otherwise healthy specimens with access to state of the art medical treatment. Unfortunately, remote populations or those in the third world will probably be decimated, but it was ever thus (cf HIV/AIDS).

the last pandemic really was unusual in that it really did target young adults. And viral diseases are the ones that we have made the least progress on!

"A remarkable feature of the 1918 pandemic was that deaths were highest among young adults in the 20–40 year age range"...

The 1918 influenza A pandemic claimed more than 20 million lives worldwide in less than a year and ranks among the worst disasters in human history. In the United States alone, it is estimated that 1 in 4 people became ill during the pandemic and that 675,000 people died....

Doubt remains as to whether the 1918 influenza pandemic originated in the United States, China, or France. There is agreement that a mild wave occurred simultaneously in the United States, Europe, and Asia in March–April 1918. It is postulated that genetic changes in that virus resulted in high pathogenicity in the second wave. The second wave occurred in September–November 1918 and affected one-quarter of the world’s population; 500 million people were clinically affected during the pandemicThe return of military personnel throughout the world coincided with the peak of the second wave. In many cities, the disease was so severe that coffins were stacked in the streets, and the impact was so profound that it depressed the average life expectancy in the United States by more than 10 years. In spring 1919, a nasty but less lethal third wave occurred, and substantial mortality also recurred in 1920 "